Abnormal invasive hemodynamics in heart transplant recipients: A single-center, retrospective study

BACKGROUND Few studies have quantified invasive hemodynamic parameters in post heart transplant recipients. AIM To report the incidence of abnormal hemodynamics in heart transplant recipients at 1-year and 3-year post-transplant and determine if there was any correlation with recipient and donor characteristics. METHODS Data from 279 consecutive heart transplant recipients from 2007 through 2020 were analyzed. Clinical variables regarding both recipients and donors as well as hemodynamic variables obtained via right heart catheterization during 1-year and 3-year annual testing were recorded. Simple and multiple linear regression tests were used to determine how recipient and donor variables influenced hemodynamic parameters at 1-year and 3-year. RESULTS Data were available for 260 patients and 224 patients at 1-year and 3-year post-transplant respectively. At 1-year, abnormal hemodynamic parameters were common with 24% patients having right atrial pressure (RAP) > 10 mmHg, 52% with mean pulmonary artery pressure > 20 mmHg, and 12% with pulmonary capillary wedge pressure (PCWP) > 18 mmHg. Similar abnormalities were noted at 3-year post-transplant. Recipient body mass index (BMI) demonstrated the strongest correlation with all 3 variables at both 1-year and 3-year by multivariate linear regression analysis (P < 0.001 for both). Both donor age and predicted heart mass difference between recipient and donor were significantly linked to RAP and PCWP at 1-year but did not predict any variables at 3-year post-transplant. CONCLUSION Abnormal hemodynamics are common at 1-year and 3-year post-transplant and are associated with recipients with high BMI.